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Validation of fluorescence devices for evaluation of white spot lesions in orthodontic patients

  • Original Scientific Article
  • Published:
European Archives of Paediatric Dentistry Aims and scope Submit manuscript

Abstract

Aim

To clinically validate the fluorescence devices, DIAGNOdent Pen™ and Vista Proof™ for the evaluation of non-cavitated white spot lesions (WSL) in orthodontic patients and using direct visual examination after the brackets removal, as the gold standard.

Methods

The sample consisted of 31 patients, 13–28 years old, under fixed appliance orthodontic treatment. Teeth (N = 619) were evaluated with the brackets on, after cleaning and air drying, by direct, indirect visual examination and using the DIAGNOdent Pen™ device. After debonding with direct visual examination and the Vista Proof™ device. WSL were scored with the Gorelick Index for visual examination. The fluorescence devices were validated by calculating sensitivity, specificity and accuracy while ROC curves and area under the curve were used for comparison among the examination methods.

Results

Among the different diagnostic methods, visual examination recorded the highest degree of accuracy. The performance of the fluorescence devices was poor compared with that of the visual methods for mild WSL, while for more extended lesions no difference was found. A comparison between the validity of the two devices’ showed no statistically significant difference.

Conclusions

The validity of DIAGNOdent Pen™ and Vista Proof™ for the chairside diagnosis and quantification of non-cavitated WSL in orthodontic patients was moderate, and no better as compared to the visual diagnostic methods. The fluorescence devices performed similarly to the visual examination for more extended WSL and poorer for milder ones. Validity between the two devices did not differ.

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References

  • Al Khateeb S, Forsberg CM, de Josselin de Jong E, Angmar-Mansson B. A longitudinal laser fluorescence study of WSL in orthodontic patients. Am J Orthod Dentofac Orthop. 1998;113:595–602.

    Article  Google Scholar 

  • Alencar CJ, Braga MM, de Oliveira E, Nicolau J, Mendes FM. Dye-enhanced laser fluorescence detection of caries lesions around brackets. Lasers Med Sci. 2009;24:865–70.

    Article  PubMed  Google Scholar 

  • Alexander SA. The effect of fixed orthodontic and functional appliances on enamel decalcifications in early class II treatment. Am J Orthod Dentofac Orthop. 1993;103:45–7.

    Article  Google Scholar 

  • Aljehani A, Tranaeus S, Forsberg CM, Angmar-Mansson B, Shi XQ. In vitro quantification of white spot enamel lesions adjacent to fixed orthodontic appliances using quantitative light-induced fluorescence and DIAGNOdent. Acta Odontol Scand. 2004;62:313–8.

    Article  PubMed  Google Scholar 

  • Aljehani A, Yousif MA, Angmar-Mansson B, Shi XQ. Longitudinal quantification of incipient carious lesions in postorthodontic patients using a fluorescence method. Eur J Oral Sci. 2006a;114:430–4.

    Article  PubMed  Google Scholar 

  • Aljehani A, Bamzahim M, Yousif MA, Shi XQ. In vivo reliability of an infrared fluorescence method for quantification of carious lesions in orthodontic patients. Oral Health Prev Dent. 2006b;4:145–50.

    PubMed  Google Scholar 

  • Almosa NA, Lundgren T, Aldrees AM, Birkhed D, Kjellberg H. Diagnosing the severity of buccal caries lesions in governmental and private orthodontic patients at debonding, using the ICDAS-II and the DIAGNOdent Pen. Angle Orthod. 2014;84:430–6.

    Article  PubMed  Google Scholar 

  • Artun J, Thylstrup A. Clinical and scanning electron microscopic study of surface changes of incipient caries lesions after debonding. Scand J Dent Res. 1986;94:193–201.

    PubMed  Google Scholar 

  • Benson PE, Pender N, Higham SM. Quantifying enamel demineralization from teeth with orthodontic brackets—a comparison of two methods. Eur J Orthod. 2003;25:149–58.

    Article  PubMed  Google Scholar 

  • Benson PE, Shah AA, Willmot DR. Measurement of white lesions surrounding orthodontic brackets: captured slides vs digital camera images. Angle Orthod. 2005;75:226–30.

    PubMed  Google Scholar 

  • Boersma JG, van der Veen MH, Lagerweij MD, Bokhout B, Prahl-Andersen B. Caries prevalence measured with QLF after treatment with fixed orthodontic appliances: influencing factors. Caries Res. 2005;39:41–7.

    Article  PubMed  Google Scholar 

  • Boyle U, Walsh T, Pretty IA, Tickle M. Comparison of photographic and visual assessment of occlusal caries with histology as the reference standard. BMC Oral Health. 2012;12:10.

    Article  Google Scholar 

  • De Benedetto MS, Morais CC, Novaes TF, et al. Comparing the reliability of a new fluorescence camera with conventional laser fluorescence devices in detecting caries lesions in occlusal and smooth surfaces of primary teeth. Lasers Med Sci. 2011;26:157–62.

    Article  PubMed  Google Scholar 

  • Diniz MB, Campos PH, Sanabe ME, et al. Effectiveness of fluorescence-based methods in monitoring progression of noncavitated caries-like lesions on smooth surfaces. Oper Dent. 2015;40:230–41.

    Article  Google Scholar 

  • Geiger AM, Gorelick L, Gwinnett AJ, Griswold PG. The effect of a fluoride program on white spot formation during orthodontic treatment. Am J Orthod Dentofac Orthop. 1988;93:29–37.

    Article  Google Scholar 

  • Gomez J, Tellez M, Pretty IA, Ellwood RP, Ismail AI. Non-cavitated carious lesions detection methods: a systematic review. Community Dent Oral Epidemiol. 2013;41:54–66.

    Article  PubMed  Google Scholar 

  • Gorelick L, Geiger AM, Gwinnett AJ. Incidence of white spot formation after bonding and banding. Am J Orthod. 1982;81:93–8.

    Article  PubMed  Google Scholar 

  • Livas C, Kuijpers-Jagtman AM, Bronkhorst E, Derks A, Katsaros C. Quantification of WSL around orthodontic brackets with image analysis. Angle Orthod. 2007;78:585–90.

    Article  Google Scholar 

  • Lopatiene K, Borisovaite M, Lapenaite E. Prevention and treatment of white spot lesions during and after treatment with fixed orthodontic appliances: a systematic literature review. J Oral Maxillofac Res. 2016;7(2):e1.

    PubMed  PubMed Central  Google Scholar 

  • Lovrov S, Hertrich K, Hirschfelder U. Enamel demineralization during fixed orthodontic treatment—incidence and correlation to various oral-hygiene parameters. J Orofac Orthop. 2007;68:353–63.

    Article  PubMed  Google Scholar 

  • Mitchell L. Decalcification during orthodontic treatment with fixed appliances—an overview. Br J Orthod. 1992;19:199–205.

    Article  PubMed  Google Scholar 

  • Mizrahi E. Surface distribution of enamel opacities following orthodontic treatment. Am J Orthod. 1982;82:62–7.

    Article  PubMed  Google Scholar 

  • Moriyama CM, Rodrigues JA, Lussi A, Diniz MB. Effectiveness of fluorescence-based methods to detect in situ demineralization and remineralization on smooth surfaces. Caries Res. 2014;48:507–14.

    Article  PubMed  Google Scholar 

  • Novaes TF, Moriyama CM, De Benedetto MS, et al. Performance of fluorescence-based methods for detecting and quantifying smooth-surface caries lesions in primary teeth: an in vitro study. Int J Paediatr Dent. 2016;26:13–9.

    Article  PubMed  Google Scholar 

  • Øgaard B, Rǿlla G, Arends J. Orthodontic appliances and enamel demineralization. Part 1: lesion development. Am J Orthod Dentofac Orthop. 1989;94:68–73.

    Article  Google Scholar 

  • Rodrigues JA, Hug I, Diniz MB, Lussi A. Performance of fluorescence methods, radiographic examination and ICDAS II on occlusal surfaces in vitro. Caries Res. 2008;42:297–304.

    Article  PubMed  Google Scholar 

  • Seremidi K, Lagouvardos P, Kavvadia K. Comparative in vitro validation of VistaProof and DIAGNOdent pen for occlusal caries detection in permanent teeth. Oper Dent. 2012;37:234–45.

    Article  PubMed  Google Scholar 

  • Staudt CB, Lussi A, Jacquet J, Kiliaridis S. WSL around brackets: in vitro detection by laser fluorescene. Eur J Oral Sci. 2004;112:237–43.

    Article  PubMed  Google Scholar 

  • Twetman S, Axelsson S, Dahlen G, et al. Adjunct methods for caries detection: a systematic review of literature. Acta Odontol Scand. 2013;71:388–97.

    Article  PubMed  Google Scholar 

  • Van der Veen MH, Mattousch T, Boersma JG. Longitudinal development of caries lesions after orthodontic treatment evaluated by quantitative light-induced fluorescence. Am J Orthod Dentofac Orthop. 2007;131:223–8.

    Article  Google Scholar 

  • Willmot DR, Benson PE, Pender N, Brook AH. Reproducibility of quantitative measurement of white enamel demineralisation by image analysis. Caries Res. 2000;34:175–81.

    Article  PubMed  Google Scholar 

  • Zachrisson BU. Direct bonding in orthodontics. Am J Orthod. 1977;71:173–89.

    Article  PubMed  Google Scholar 

  • Zachrisson BU, Zachrisson S. Caries incidence and orthodontic treatment with fixed appliances. Scand J Dent Res. 1971;79:183–92.

    PubMed  Google Scholar 

  • Zhou XH, Obuchowski NA, McClish DK. Statistical methods in diagnostic medicine. 2nd ed. New York: Wiley; 2011.

    Book  Google Scholar 

Download references

Funding

Partially funded from ‘Kapodistrias’, University of Athens, 70/04/7551. It is a small University Grand (1000 euro) to support minor expenses for the study.

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Authors and Affiliations

  1. Department of Paediatric Dentistry, School of Dentistry, National and Kapodistrian University of Athens, 2 Thivon Str., Goudi, Greece

    K. Kavvadia, K. Seremidi & C. Reppa

  2. Department of Orthodontics, School of Dentistry, National and Kapodistrian University of Athens, 2 Thivon Str., Goudi, Greece

    M. Makou

  3. Department of Operative Dentistry, School of Dentistry, National and Kapodistrian University of Athens, 2 Thivon Str., Goudi, Greece

    P. Lagouvardos

Authors
  1. K. Kavvadia
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  2. K. Seremidi
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  3. C. Reppa
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  4. M. Makou
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  5. P. Lagouvardos
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Corresponding author

Correspondence to K. Kavvadia.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

The study has been performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. Approval was obtained from the ethics committee of the Dental School of the University of Athens (no. 111, 22/01/2009).

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Kavvadia, K., Seremidi, K., Reppa, C. et al. Validation of fluorescence devices for evaluation of white spot lesions in orthodontic patients. Eur Arch Paediatr Dent 19, 83–89 (2018). https://doi.org/10.1007/s40368-018-0327-y

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  • DOI: https://doi.org/10.1007/s40368-018-0327-y

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